Port officials expect more revenue if service is added but unsure it would cover required ambulance upgrade

The Port Washington ambulance department would have brought in at least $68,000 in additional revenue last year if it had a paramedic unit, Fire Chief Mark Mitchell said.

But whether that amount would be enough to cover the additional cost of a paramedic program has not been determined, Mitchell said.

“We can’t make that assumption until we know what our costs are,” he said. “Whether it’s going to pay for the extra costs, we don’t know yet. It’s totally based on our service.”

That extra revenue would cover the cost of upgrading the Port department’s heart monitors to meet paramedic requirements, Mitchell said.

A feasibility study being undertaken by the department will determine what the additional costs of a paramedic program are, he said.

“The studies so far indicate it will cover the cost,” said Bruce Becker, a Police and Fire Commission member who also serves on the committee investigating the feasibility of a paramedic unit in Port.

That’s important, said commission chairman Rick Nelson.

“I think it would be a problem if we’re not cost neutral,” Nelson said. “We’d have a hard time convincing citizens or the council to bear the cost.”

The feasibility study will determine whether the additional revenue will cover the cost, Mitchell said.

“I think we just have to get reassurance this cost will not be passed on to taxpayers,” he said. “The increase in service to the patient is going to be tremendous.”

The biggest cost is likely to be the salaries for the part-time paramedics Port envisions hiring for its program, Mitchell said.

A paramedic program must be run around-the-clock, although the state will give the city two years to phase in the program, he said.

“The biggest concern is can we staff it,” Mitchell said.

The city would also need to pay the initial cost of the medications used by paramedics on calls, he said. The cost, however, would be reimbursed as patients use the medications and are billed for them.

Mitchell said the revenue estimate came from Life Quest, the firm that handles the billing for the ambulance. The firm did not look at every call the department handled but instead looked at expected fee increases when making its estimate.

Currently, the city calls the Thiensville paramedic unit when its skills are needed for a call.

From the end of 2007 through the end of 2009, the city paid Thiensville $5,300 to handle 27 so-called intercept calls for paramedic services, Mitchell said.

“That’s money we gave them that we could have kept,” he told the Police and Fire Commission recently.

This year, Port has already called Thiensville for paramedic services about a half-dozen times, he added.

When Thiensville’s paramedic unit is called, half the revenue from those calls is sent to Thiensville to cover its costs.

The city uses a set of protocols to determine when paramedics should be called. There are other times, however, when patients might also benefit from paramedic services, such as times when the patient’s condition changes en route to the hospital, Mitchell said.

“There are gray areas where we could use paramedics” he said.

If Port institutes a paramedic service, there will be paramedics on every call, Mitchell said.

“With paramedics, just the whole level of care increases,” he said. “Their level of training gets them to the point where they recognize things we can’t.”

Patients would only be billed for the paramedic services when they are required on an ambulance run, Mitchell said. That’s no different than today, he noted, because patients are billed based on the level of service required.

A patient receiving basic care for a minor injury is billed at a lower rate than those requiring more intensive care, he said.

The study committee is continuing to look into the costs and revenues associated with a paramedic unit, Mitchell said, as well as the staffing issues.

By mid-summer, he said, the department hopes to hold a public hearing on the paramedic proposal.